Background: Surgical debridement is the “gold standard” for infected pancreatic necrosis. Advances in imaging methods and minimal access techniques have changed the management of many surgical conditions and even infected pancreatic necrosis has successfully been treated in selected patients. However, technical advances don’t obviate sound clinical judgment. Aim was to consider recent advances in minimal access surgery, this article retrospectively analyses the role of open surgery and laparoscopic techniques in the management of necrotizing pancreatitis.Methods: A retrospective study of 30 cases of pancreatic necrosectomy admitted and managed during 2012-2016 was carried out and compared with results available in the existing literature.Results: Out of 30 cases, 20 were men and 10 were women. Patients' age ranged from 23 to 70 years (mean age - 49.8 years). The mean operating time was 103.8 min (range, 60-120 min). Timing of necrosectomy was 21-32 days (average - 25.5 days). The average duration of hospital stay after the procedure was 17.4 days (range, 10-21 days).Conclusions: Comparative analysis of results of different surgical techniques reveals that there is no significant difference in terms of mortality. However, overall rate of complications and failure (inadequate debridement and drainage) are still higher with minimally invasive techniques.

Primary cutaneous mucormycosis is a consequence of environmental Mucorales spores inoculation at the abraded skin. In a diabetic patient, these spores germinate quickly and disseminate hematogenously to the surroundings. Cutaneous mucormycosis is a rare but aggressive, invasive, and life-threatening fungal infection. Its presentation is nonspecific, but it rapidly results in necrosis of underneath tissues. Diagnosis can be readily made by KOH wet mount of excise tissue. However, a prompt diagnosis with multidisciplinary management is a prerequisite for a better outcome. We present a case of fatal cutaneous mucormycosis caused by Apophysomyces elegans, in a diabetic patient who succumbed to death despite extensive debridement and antifungal treatment.

INTRODUCTIONThe prevalence of TB has been rising in recent years globally. It is estimated that in 2010 there were 8.8million (range: 8.5-9.2million) new cases of TB. On the other hand, TB is the cause of death for approximately two million people every year.1-3 Aging, changes in life style, socioeconomic factors, and population growth have lead to an increased prevalence of DM, particularly, type 2 DM. The total number of ABSTRACT Background: The burden of diabetes mellitus is increasing worldwide. The prevalence of TB has been rising in recent years globally. Aging, changes in life style, socioeconomic factors, and population growth have lead to an increased prevalence of DM, particularly, type 2 DM. Diabetes Mellitus (DM) almost triples the risk of developing tuberculosis (TB). India, the nation with the highest number of TB cases in the world, is also undergoing epidemic growth in DM rates. With the demographic transition underway globally, increase in life expectancy, improvements in provision of health services and a subsequent increase in the elderly population, the absolute numbers of cases of diabetes will increase exponentially. As a result, DM and TB are increasingly present together, and this calls for renewed interest in this topic. Various studies done in different parts of India and in other parts of globe where TB is endemic have shown a higher prevalence of DM among PT infected with tuberculosis. We in our study undertaken in Department of medicine in IIMS&R Lucknow UP found a high prevalence of DM amongst TB patients. Routine screening of TB patients for DM will help detect cases of diabetes and pre-diabetes early, so that primary prevention methods may be initiated early and effectively. Methods: This hospital-based cross-sectional study was undertaken in Department of medicine in IIMS and R Lucknow UP. All TB cases more than 18 years of age, including new and re-treatment cases, sputum positive, sputum negative and extra-pulmonary cases currently on treatment in the were included in the study. Results: Using the diagnostic criteria, as mentioned in the methodology, the prevalence of diabetes among TB patients in this study was found to be 24.5% of which 18.5% were known DM cases and 5.9% were newly diagnosed. Conclusions: The burden of diabetes mellitus is increasing worldwide. The association between diabetes and tuberculosis is the next challenge for global tuberculosis control. Improved understanding of the bidirectional relationship of the two diseases is necessary for proper planning and collaboration to reduce the dual burden of diabetes and TB. In people with TB, it may be appropriate to actively screen for DM. Prevention, screening, and treatment of both diseases together is more effective.

Background: Chronic obstructive pulmonary disease is a leading cause of morbidity and mortality in adults all over the world. Pulmonary hypertension (PH) is a severe disorder defined by a mean pulmonary artery pressure of ≥25 mmHg at rest. Pulmonary hypertension can occur as an isolated disease or as a consequence of a number of underlying diseases and conditions, such as heart failure and chronic obstructive pulmonary disease (COPD). The aim of our study was to study the prevalence of pulmonary hypertension in COPD patients and to highlight the importance of early diagnosis of pulmonary hypertension to prevent further complications.Methods: This was a retrospective observational hospital based study conducted at Integral Institute of Medical Sciences and Research Lucknow U P, during 1st January to 31st December 2017. A total of 210 patients were evaluated for presence of pulmonary hypertension using chest X-ray, electrocardiogram, 2D echocardiography.Results: The present study finding reveals 38.02 % patients of various severity of COPD have findings of pulmonary hypertension, that is similar in prevalence of previous studies.Conclusions: The prevalence of PH in patients with COPD was 38.02%. As PH has an important role in the prognosis of COPD patients, it should be evaluated in as many COPD patients as possible.